Document Detail

Brief followup report: Does high-flexion total knee arthroplasty allow deep flexion safely in Asian patients?
MedLine Citation:
PMID:  23054521     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The long-term survivorship of TKA in Asian countries is comparable to that in Western countries. High-flexion TKA designs were introduced to improve flexion after TKA. However, several studies suggest high-flexion designs are at greater risk of femoral component loosening compared with conventional TKA designs. We previously reported a revision rate of 21% at 11 to 45 months; this report is intended as a followup to that study.
QUESTIONS/PURPOSES: Do implant survival and function decrease with time and do high-flexion activities increase the risk of premature failure?
METHODS: We prospectively followed 72 Nexgen LPS-flex fixed TKAs in 47 patients implanted by a single surgeon between March 2003 and September 2004. We determined the probability of survival using revision as an end point and compared survival between those who could and those who could not perform high-flexion activities. Minimum followup was 0.9 years (median, 6.5 years; range, 0.9-8.6 years).
RESULTS: Twenty-five patients (33 knees) underwent revision for aseptic loosening of the femoral component at a mean of 4 years (range, 1-8 years). The probability of revision-free survival for aseptic loosening was 67% and 52% at 5 and 8 years, respectively. Eight-year cumulative survivorship was lower in patients capable of squatting, kneeling, or sitting crosslegged (31% compared with 78%). There were no differences in the pre- and postoperative mean Hospital for Special Surgery scores and maximum knee flexion degrees whether or not high-flexion activities could be achieved.
CONCLUSIONS: Overall midterm high-flexion TKA survival in our Asian cohort was lower than that of conventional and other high-flexion designs. This unusually high rate of femoral component loosening was associated with postoperative high-flexion activities.
Hyuk-Soo Han; Seung-Baik Kang
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-02     Completed Date:  2013-05-22     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1492-7     Citation Subset:  AIM; IM    
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MeSH Terms
Arthroplasty, Replacement, Knee* / adverse effects,  instrumentation
Asian Continental Ancestry Group*
Biomechanical Phenomena
Chi-Square Distribution
Disability Evaluation
Follow-Up Studies
Kaplan-Meier Estimate
Knee Joint / physiopathology,  radiography,  surgery*
Knee Prosthesis
Life Style / ethnology
Middle Aged
Prospective Studies
Prosthesis Failure
Range of Motion, Articular
Recovery of Function
Republic of Korea / epidemiology
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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